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Nationwide rates for HCPCS A5514

For diabetics only, multiple density insert, made by direct carving with CAM technology from a rectified CAD model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of Shore A 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.42 / $34.47 / $39.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.13 / $33.42 / $46.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.08 / $56.78 / $98.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.75 / $30.75 / $44.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.60 / $35.60 / $35.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.99 / $34.40 / $43.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.60 / $26.98 / $43.56